Secondhand smoke effects studied among Amish

Robert M. Reed, a pulmonary and critical care specialist at the University of Maryland, uses a spirometer to measure lung function. He found while studying an Amish community in Lancaster that even a small amount of secondhand smoke exposure can have negative effects.(Photo: Algerina Perna / The Baltimore Sun)

BALTIMORE — In bucolic Lancaster County, the Amish people grow their own tobacco. In keeping with traditional gender roles, the men smoke the tobacco in cigars, pipes or cigarettes, while the women largely tend not to smoke.

A recent study of the Old Order Amish community by University of Maryland researchers has nonetheless found them to be just as susceptible to a scourge of modern day life — health problems related to exposure to secondhand smoke.

It turned out that the male smokers were potentially harming the women by smoking.

The study by Robert M. Reed, a University of Maryland associate professor of medicine and the lead researcher, found that exposure to even low amounts of secondhand smoke damaged the lung function of Amish family members, particularly the nonsmoking women, in a small-but-measurable way.

Reed said Amish men typically gather on Sundays to smoke, so he wasn’t sure he would find anything noteworthy because the amount of secondhand smoke Amish families were exposed to was likely very low.

“It was surprising that we found anything at all, and I think that this really tells us how detrimental secondhand smoke can be,” said Reed, who is also a pulmonary and critical care specialist at the University of Maryland Medical Center.

Tips the scale: “I think there are some open questions of the certainty to which we can say that secondhand smoke exposure causes some things like obesity or diabetes, or a lower lung function. And I think our study tips the scale to make it more clear that those are also some of the ill effects.”

The study was published in the medical journal PLOS ONE in March.

The researchers examined data on a cross-section of 3,568 Amish who participated in three community surveys of cardiovascular health between 2001 and 2015, according to the University of Maryland Medical System. The data included tobacco use and secondhand smoke exposure from family members.

Because the researchers had records of familial relations in the community, they were able to determine which people had a father, brother or husband who was a smoker and thus conclude that they had been exposed to secondhand smoke. The researchers also tested lung function and took blood samples.

The researchers did not have to account for potential smoke exposure in the womb since women in the Amish community generally do not smoke. About a third of Amish men in the study smoked, with 64 percent smoking cigars, 46 percent smoking cigarettes and 21 percent smoking pipes. Reed said cigar and pipes produce more noxious secondhand smoke than cigarettes.

Study: Reed said the team used liaisons who work with the Amish community. Other researchers have studied the Amish because their lifestyles allow for scientists to control for fewer variables.

“There have been a lot of studies on the effects of secondhand smoking,” Reed said. “But a lot of those studies have been kind of difficult to tease out what’s a true affect of the smoking and what may be related to other factors that are associated with the behavior of smoking,” such as socioeconomic status.

The Amish, he said, are more physically active than the average American, they eat more fruits and vegetables, they all live in the country ,and their diets are generally similar to each other.

Reed found that women who were exposed to secondhand smoke had a higher body mass index on average. Their LDL or “bad” cholesterol was higher, while their HDL or “good” cholesterol was lower. Their fasting glucose levels, an indicator of metabolic health, were also higher among those who had been exposed to secondhand smoke.

Points: The researchers assigned each person a point for every nuclear family member they had that was a smoker, and the women with more family members who smoked had poorer metabolic health markers overall.

Men who were nonsmokers but who had been exposed to secondhand smoke also were more likely to be

heavier, have higher LDL cholesterol and have higher fasting glucose readings. Reed found a reduction in lung function of about 2.7 percent for women who had been exposed to secondhand smoke.

Some 480,000 Americans die each year from smoking-related causes, with about 41,000 of those suffering from lung cancer and coronary heart disease related to secondhand smoke exposure, according to a 2014 report by the Office of the Surgeon General. Previous studies have established stroke, lung cancer and coronary heart disease as associated with secondhand smoke exposure.

Some 58 million people in the U.S. were exposed to secondhand smoke in 2012, the latest year for which data is available, according to the Centers for Disease Control and Prevention, although that number has been cut in half since 2000. Exposure was higher for children, black people, renters and those living in poverty.